Active NPI
Mixed Workd Therapy Ga LLC
- Mental Health Counselor
- McDonough, GA
National Provider Identifier
1114838513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- MIXED WORKD THERAPY GA LLC
- Practice address
- 1564 Airline Rd
McDonough, GA 30252-2684 - Phone
- (404) 819-6889
- NPI assigned
- Sep 15, 2026
- Organization subpart
- Yes
- Parent organization
- MIXED WORLD THERAPY LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Christen McDonald, PHD
- Title
- Founding Clinical Director
- Phone
- (404) 819-6889
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1564 Airline Rd
McDonough, GA 30252-2684
Mailing address
1564 Airline Rd
McDonough, GA 30252-2684
Phone (404) 819-6889
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1789430400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1789430400000",
"number": "1114838513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1564 AIRLINE RD",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302522684",
"telephone_number": "404-819-6889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1564 AIRLINE RD",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302522684",
"telephone_number": "404-819-6889"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIXED WORKD THERAPY GA LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MIXED WORLD THERAPY LLC",
"enumeration_date": "2026-09-15",
"last_updated": "2026-09-15",
"certification_date": "2026-09-15",
"status": "A",
"authorized_official_last_name": "MCDONALD",
"authorized_official_first_name": "CHRISTEN",
"authorized_official_title_or_position": "FOUNDING CLINICAL DIRECTOR",
"authorized_official_telephone_number": "404-819-6889",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McDonough, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.